병리검사 처방오류 개선 시스템 구축

이현임,최영진,구숙희,양승주,김병로,김묘정,신일근,신미옥,서임선 한국의료QA학회 2006 한국의료질향상학회지 Vol.13 No.2

문제: 조직병리검사의 처방이 복잡하고 전문화됨에 따라 오류처방이 빈번하게 발생되고 이를 해결하기위한 프로세스가 복잡하여 부서간의 갈등과 업무의 가중, 또한 병원 수입 감소가 초래되었다. 목적: 발생된 오류처방의 유형과 발생율, 오류처방을 해결하기 위한 프로세스를 파악하여 이에 대한 문제점을 개선하여 업무의 효율성과 관련부서간의 부가업무 감소와 갈등해소, 더불어 병원수익을 향상시키는 것에 목표를 두고 활동하였다. 의료기관: 서울시에 소재한 종합병원 질 향상 활동: 조직병리검사 처방의 오류처방 발생 원인과 유형, 발생율을 조사하여 원인을 파악하고 개선을 위한 프로세스를 구축하여 질 향상을 도모하였다. 개선효과: 수술실에서 의뢰한 외과 입원환자의 일반조직병리검사 오류율은 개선 전 7.8%에서 개선 후 3.5%, 동결절편조직검사 오류율은 개선 전 28.6%에서 개선 후 0%로 이전보다 모두 개선되었다. 또한 수술실 간호사의 업무 만족도는 일반조직병리검사의 처방시 95%, 동결절편조직검사 처방시 90%로 높은 만족도를 보였다. 단 병리과의 경우 업무가 증가됨에 따라 초과근무시간이 증가하였다.

치매간호중재 프로그램이 경증 치매노인의 Na, K, Ca, Cl, P, Cholesterol의 혈중농도 및 17-KS, 17-OHCS의 뇨배설량에 미치는 영향

나현주,조명숙,임욱빈 대한기초간호자연과학회 2002 Journal of korean biological nursing science Vol.4 No.2

This study was conducted for the evaluation of the effect of Dementia prevention nursing program on Urinary 17-KS, 17-OHCS, and Blood Na, Cl, K, Ca, P, cholesterol. The sample for the present study was composed of 16 demented elderly in D care center for the eldery in K city. The Dementia prevention nursing program consisted of concept memory training, music therapy, and art therapy. The program was performed twice a week and about ninety minutes was consumed for one session. The program had been administered for 8 weeks. We checked Urinary 17-KS, 17-OHCS, and Blood Na, Cl, K, Ca, P, cholesterol befor and after the program. Statistical analysis was performed by using descriptive statistics and Wlicoxon signed rank test of SAS system for window 6.12. The result were follows : 1. Urinary 17-KS 17-KS score increased significantly after intervention(p=0.005). 2. Urinary 17-OHCS 17-KS score increased significantly after intervention(p=0.00l). 3. Blood Na, Cl, K, Ca, P, cholesterol Na(p=0.0002), Cl(p=0.0001) K(p=0.0001), Ca(p=0.0028) decreased significantly after intervention. The results show that Dementia prevention nursing program increases Urinary 17-KS, the Dementia 17-OHCS, and decreases Blood Na, Cl, K, Ca, P, cholesterol. In conclusion, prevention nursing program can be used for the effective measure to decrease stress of the Demented elderly.

상부소환관협착에 대한 Savary-Gilliard Dilatation의 치료효과와 안전성에 관한 관찰

정현용,육은주,임의혁,김병호,성자원,이기천,허승식,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2

For the patient with stenosis of upper digestive tract caused by either benign or malignant process, esophageal dilatation is an important therapeutic modality. We reviewed retrospectively 39 cases treated by Savary-Gilliard dilatation for upper digestive tract stenosis, and results were follows : (1) Dysphagia was improved in 95% of the patients. (2) Eight patients(20%) sufferd perforation, five of them were managed with conservative medical measures, others were managed operatively. (3) In the cases with benign stenosis dysphagia was not noticed for 8.8 months, but with malignant stenosis dysphagia was reappeared after 2.8 months despite concomitant chemoradiotherapy. In conclusion, Savary-Gilliard dilatation was an effective measure for symptome due to upper digestive tract stenosis, but more careful attention for perforation should be necessitated. Also another therapeutic modality for treatment of malignant stenosis was inevitable.

Glutamate 억제제가 Pilocarpine에 의한 경련 및 기억장애에 미치는 영향

천임순,한형수,박정숙,정헌주,이만기,김중영 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.3

목적 : Pilocarpine에 의한 경련 및 기억력 저하에 glutamate 수용체가 관련이 있는지 검토하였다. 대상 및 방법 : 생쥐에 pilocarpine을 투여하여 야기되는 경련 및 기억력저하가 glutamate 수용체 길항 약물인 MK-801 및 NBQX를 전처치하였을 때의 반응을 Morris Water Maze의 방법으로 관찰하였다. 결과 : MK-801과 NBQX를 전처치하고 pilocarpine을 투여하였는 바 pilocarpine에 의한 경련유발은 억제되지 않았으나, pilocarpine에 의한 reference memory와 working memory의 저하는 MK-801이나 NBQX를 처치로서 억제되었다. 결론 : Pilocarpine에 의한 경련작용에 비하여 기억력저허가 glutamte 수용체와 관련이 있는 것으로 보인다. The role of glutamate receptors in the genesis of pilocarpine-induced seizure and seizure-related memory deficit was studied using MK-801 and NBQX. After pretreatment with MK-801 or NBQX, pilocarpine was administered intraperitoneally. Both drugs had no effect on the behavioral seizure activity and onset of seizure activity. Memory was tested with reference and working memory version of Morris water maze at 20th day after pilocarpine treatment. Reference and working memory deficit was produced by pilocarpine. These deficit were prevented by MK-801 or NBQX, which were given in once a day for 4 day at 7th to 10th days after pilocarpine treatment. These results show that although MK-801 and NBQX do not have anticonvulsant property they can prevent pilocarpine-induced memory deficit.

만성 간질환에 대한 DDB(Biphenyl Dimethyl Dicaboxylate)의 임상적 효과

이헌영,임의혁,김성걸,김진희,육은주,성자원,김병호,정형용,강대영,김영건 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

To investigate the effects of short-term administration of DDB(Biphenyl Dimethyl Dicarboxylate) for decreasing elevated serum aminotransferase levels in chronic liver diseases, authors applied 3 capsules of DDB per day at each meal time for 35 patients and compared with 35 patients treated with other conservative management. The following results were obtained. 1. Serum alanine aminotransferase (ALT) levels significantly decreased from 247.1± 180.0 IU/L of pretreatment level to 96.6±126.0 IU/L, 61.1±62.7 IU/L and 38.0±26.8 IU/L after 1, 3 and 6 months of treatment(p<0.05) and effective rates were observed in 60.0%, 71.4% and 88.6% of patients after 1, 3 and 6 months of treatment. 2. Serum aspartate aminotransferase (AST) levels decreased also significantly from 167.8±96.9 IU/L of pretreatment levels to 124.4±155.0 IU/L, 77.9±49.6 IU/L, 60.6± 46.9 IU/L after 1, 3 and 6 months of treatment(p<0.05), but decreasing pattern of serum AST was less significant than that of serum ALT. 3. No significant difference were observed in the serum ALT and AST changes according to the cause and duration of hepatitis. 4. No significant adverse effects were observed in whole patients treated with DDB. It is suggested that small dose administration of DDB is effective for decreasing serum aminotrans ferase levels in chronic liver disease in which other conservative management was not effective.

경증 천식 환아에서 비염의 동반이 하기도 호산구 염증에 미치는 영향

한지은,이미현,송도영,강임주 대한 소아알레르기 및 호흡기학회 2004 소아알레르기 및 호흡기학회지 Vol.14 No.2

내시경으로 진단된 소화성 궤양의 임상적 고찰

김영건,육은주,김성걸,임의혁,성자원,김병호,허승식,이기천,정현용,이헌영 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

A clinical analysis was performed of 3055 pateints with peptic ulcer who were diagnosed with gastroduodenoscopy, in Hospital of Chungnam National University College of Medicine from July 1988 to May 1993. 1) During the period 1988-1993, The proportion of gastric ulcer among peptic ulcer decreased from 47.8% to 42.8%, but that of duodenal ulcer increased from 36.8% to 39.6%. 2) Of the 3055 cases, the number of patients with esophageal ulcer was 98(3.2%), with gastric ulcer 1407(41.6%), with. duodenal ulcer 1104(36.1%), with channel ulcer 149(4.9%), and with combind ulcer 297(9.7%). 3) We observed a peak incidence of peptic ulcer in the 50-69age group, gastric ulcer in the 5069age, duodenal ulcer in the 40-59age group. The ratio of male to female was 3.6 : 1 in peptic ulcer, 4.4 : 1 in gastric ulcer, 3.0 : 1 in duodenal ulcer. 4) The common site was angle in gastric ulcer, and bulb in duodenal ulcer. 5) The active stage was 39.4% of gastric ulcer, and 37.4% of duodenal ulcer, the healing stage was 34.2% of gastric ulcer, and 17.9% of duodenal ulcer, and the scar stage of gastric ulcer was 26.4%, and duodenal ulcer was 44.7%. 6) The size of ulcer was less than 1Cm in 66.7% of gastric ulcer, and in 75.5% of duodenal ulcer, the size of ulcer was greater than 2Cm in 13.2% of gastric ulcer, and in 6.5% of duodenal ulcer. 7) The frequency of multiple ulcer was 29.9% in gastric ulcer, and 16.5% in duodenal ulcer.

말단 비대증의 임상적 특성

박은미,안용환,김현정,김병수,임종주,김하영,박병현,조정구 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.2

K+ Ion Catalysis in Nucleophilic Displacement Reaction of Y-Substituted-Phenyl Picolinates with Potassium Ethoxide: Effect of Substituent Y on Reactivity and Transition State Structure

Hyun-Ju Im,Ji Eun Lee,Mi-Yeon Kim,엄익환 대한화학회 2014 Bulletin of the Korean Chemical Society Vol.35 No.6

Pseudo-first-order rate constants (kobsd) have been measured spectrophotometrically for the nucleophilic substitution reaction of Y-substituted-phenyl picolinates (7a-f) with potassium ethoxide (EtOK) in anhydrous ethanol at 25.0 ± 0.1 oC. The plot of kobsd vs. [EtOK] curves upward while the plot of kobsd/[EtO–]eq vs. [EtO–]eq is linear with a positive intercept in all cases. Dissection of kobsd into kEtO− and kEtOK (i.e., the second-order rate constants for the reactions with the dissociated EtO– ion and ion-paired EtOK, respectively) has revealed that the ion-paired EtOK is more reactive than the dissociated EtO–. The σo constants result in a much better Hammett correlation than σ– constants, indicating that the reaction proceeds through a stepwise mechanism in which departure of the leaving group occurs after the rate-determining step (RDS). K+ ion catalyzes the reaction by increasing the electrophilicity of the reaction center through formation of a cyclic transition state (TS). The catalytic effect decreases as the substituent Y becomes a stronger electron-withdrawing group (EWG). Development of a positive charge on the N atom of the picolinyl moiety through resonance interactions is responsible for the decreasing K+ ion catalysis.

Growth, quality, and yield characteristics of transgenic potato (Solanum tuberosum L.) overexpressing StMyb1R-1 under water deficit

Im, Ju-Sung,Cho, Kwang-Soo,Cho, Ji-Hong,Park, Young-Eun,Cheun, Chung-Gi,Kim, Hyun-Jun,Cho, Hyun-Mook,Lee, Jong-Nam,Jin, Yong-Ik,Byun, Myung-Ok,Kim, Dool-Yi,Kim, Myeong-Jun The Korean Society of Plant Biotechnology 2012 식물생명공학회지 Vol.39 No.3

This study was conducted to evaluate agronomic characteristics such as growth, quality, and yields of StMyb1R-1 transgenic potato and also to obtain the basic data for establishing assessment guidelines of transgenic potato. Three transgenic lines (Myb 1, Myb 2, and Myb 8) were cultivated under conventional irrigation, drought condition, and severe drought condition and were analyzed by comparing with wild type, non-transgenic cv. Superior. Myb 2 showed a different flower color from wild type and Myb 1 had much bigger secondary leaflets than wild type. Myb 1 and Myb 2 showed higher $P_2O_5$ content in both top and root zone and longer shaped tubers than wild type. In yield factors, transgenic lines had more tubers than wild type, however their yield decreases were severe because of the poor enlargement of tuber under water deficit condition. This tendency was noticeable in Myb 1 and Myb 2. In TR ratio, chlorophyll content, dry matter rate, and relative water content, there were no big differences between transgenic lines and wild type. Meanwhile, in phenotype, growth, quality, and yield factors, substantial equivalent was confirmed between Myb 8 and wild type. Then, Myb 8 showed the highest marketable tuber yield under conventional irrigation, while showed lower level than wild type under water deficit. Judged by this result, the enhancing droughttolerance by StMyb1R-1 gene might actually not mean the enhancement of photosynthesis or starch accumulation in tuber and, furthermore, not the yield improvement. More detailed research will be required to accurately understand the relationship between StMyb1R-1 and yield factors.